Acute abdominal conditions in older adults may present without typical pain, which can delay recognition and management. A cross-sectional analysis published in Acta Diabetologica evaluated whether type 2 diabetes mellitus (T2DM) is associated with asymptomatic presentation in elderly patients with acute abdominal conditions.

The study included 215 patients aged 65 years or older who were admitted with acute abdominal conditions. Clinical, demographic, and laboratory data were extracted from medical records. The primary objective was to identify factors associated with asymptomatic acute abdomen (AAA), defined as the absence of abdominal pain at presentation. Multivariable logistic regression was used to assess associations.

The analysis showed that 33.5% of patients presented without abdominal pain. T2DM was more frequent among asymptomatic cases compared with symptomatic cases, at 44.4% versus 24.5%. In adjusted analysis, T2DM was associated with higher odds of asymptomatic presentation with an odds ratio of 1.95 (95% confidence interval [CI], 1.10–3.45). Lower heart rate and absence of fever were also associated with asymptomatic presentation. Among individuals with T2DM, longer disease duration and higher glycated hemoglobin (HbA1c) levels were linked to the absence of pain.

These findings suggest that elderly patients with long-standing and suboptimally controlled T2DM may present with acute abdominal conditions without typical pain, which may affect clinical recognition.